?AIM: Analyze the effectiveness and safety of upper eyelid combined with fascia sheath (CFS) suspension and levator muscle (LM) shortening surgery in correcting severe ptosis. ?Methods: Retrospective study. Eighty cases (84 eyes) of severe ptosis treated in our hospital from June 2018 to June 2022 were divided into two groups based on the surgical method: the CFS group 40 cases (41 eyes) underwent upper eyelid combined with fascia sheath suspension and upper eyelid levator muscle shortening surgery; 43 eyes of 40 patients in the frontal muscle group underwent frontal muscle flap suspension surgery; Compare the clinical total effective rate, postoperative complications, and patient satisfaction rate between the two groups of patients. ?Results: After 12 months of surgery, the clinical effective rates of the two groups were basically the same, and there was no statistically significant difference (P>0.05). The incidence of complications was 26% in the frontal muscle group and 10% in the CFS group, with a statistically significant difference between the two groups (P=0.034). The satisfaction rate of the frontal muscle group was 80%, while the CFS group was 97.50%. There was a statistically significant difference between the two groups (P=0.014). ?Conclusion: The use of CFS+LM surgery can effectively correct severe ptosis, with fewer complications and higher patient satisfaction.